Provider Demographics
NPI:1245242718
Name:KAPITAN, RICHARD A (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:KAPITAN
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8840 BLAKENEY PROFESSIONAL DR.
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277
Mailing Address - Country:US
Mailing Address - Phone:704-716-9840
Mailing Address - Fax:704-716-9841
Practice Address - Street 1:8840 BLAKENEY PROFESSIONAL DR.
Practice Address - Street 2:SUITE 300
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277
Practice Address - Country:US
Practice Address - Phone:704-716-9840
Practice Address - Fax:704-716-9841
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLDN161031223S0112X
NC94521223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery